Methodological Considerations in Enuresis-Treatment Research

Abstract

Three treatments for enuresis were evaluated: (a) immediate detection with a urine-sensing alarm with additional operant training procedures, (b) delayed detection with staff activating the alarm and conducting the procedures in the morning, and (c) yoked-schedule awakenings when the awakening times were determined by the performance of a randomly matched participant from the immediate-detection group. Twenty seven people with mental retardation (most profoundly or severely handicapped), whose ages ranged from 13 to 29 years, participated. Nine of the participants were noncompliant with the linen changing and practice walks to the bathroom and thus did not receive consistent treatment. All 7 of the compliant members of the immediate-detection group improved, 2 of the delayed-detection group worsened while 2 improved, and 6 of 7 yoked awakenings participants improved. Improvement negatively correlated with the frequency of baseline bed-wetting. Several methodological issues are raised concerning enuresis treatment.